Chauhan Aparna, Jain Smita
Department of Pharmacy, School of Chemical Sciences and Pharmacy, Central University of Rajasthan, Kishangarh, Rajasthan, India.
Curr Pharm Des. 2025 Apr 21. doi: 10.2174/0113816128386983250410092649.
The Blood-Brain Barrier (BBB), a dynamic and highly selective interface, regulates the exchange of molecules between the circulatory system and the Central Nervous System (CNS). While it protects the brain from toxins and pathogens, it also restricts the delivery of therapeutic agents, posing a significant challenge in treating CNS disorders such as Alzheimer's disease, Parkinson's disease, and glioblastoma. This manuscript explores the structural and functional complexity of the BBB, including the roles of tight junctions, adherens junctions, astrocytes, pericytes, and endothelial cells. It highlights the influence of drug physicochemical properties, such as lipophilicity, molecular weight, and hydrogen bonding, on BBB penetration. Current strategies to enhance drug delivery include nanotechnology-based carriers (liposomes, solid lipid nanoparticles, polymer-based carriers), receptor-mediated transcytosis, and cell-penetrating peptides. Emerging approaches like focused ultrasound with microbubbles, intranasal delivery, and exosome-mediated transport demonstrate significant potential for bypassing BBB constraints. Gene therapy, employing both viral and nonviral vectors, offers promise for addressing genetic CNS disorders. Despite advances, limitations, such as offtarget effects, limited delivery efficiency, and potential toxicity, remain critical barriers to clinical translation. Future research must prioritize multidisciplinary approaches integrating nanotechnology, personalized medicine, and enhanced understanding of BBB biology. Innovations in non-invasive, targeted delivery systems are essential to overcoming existing challenges and enabling effective treatment of CNS disorders. This review underscores the need for further exploration of these technologies to achieve sustained, site-specific drug delivery, thereby advancing therapeutic interventions for neurological diseases. Significance Statement: The blood-brain barrier (BBB) is a critical interface that protects the brain but limits drug delivery, posing challenges in treating CNS disorders. Advancing multidisciplinary approaches and innovative delivery systems is essential to overcome these limitations and enable effective therapies for neurological diseases.
血脑屏障(BBB)是一个动态且高度选择性的界面,它调节着循环系统与中枢神经系统(CNS)之间分子的交换。虽然它能保护大脑免受毒素和病原体的侵害,但同时也限制了治疗药物的递送,这在治疗诸如阿尔茨海默病、帕金森病和胶质母细胞瘤等中枢神经系统疾病时构成了重大挑战。本手稿探讨了血脑屏障的结构和功能复杂性,包括紧密连接、黏附连接、星形胶质细胞、周细胞和内皮细胞的作用。它强调了药物物理化学性质,如亲脂性、分子量和氢键,对血脑屏障穿透的影响。当前增强药物递送的策略包括基于纳米技术的载体(脂质体、固体脂质纳米颗粒、基于聚合物的载体)、受体介导的转胞吞作用和细胞穿透肽。聚焦超声联合微泡、鼻内给药和外泌体介导的转运等新兴方法显示出绕过血脑屏障限制的巨大潜力。采用病毒和非病毒载体的基因治疗为解决遗传性中枢神经系统疾病带来了希望。尽管取得了进展,但诸如脱靶效应、递送效率有限和潜在毒性等限制仍然是临床转化的关键障碍。未来的研究必须优先考虑整合纳米技术、个性化医学以及对血脑屏障生物学更深入理解的多学科方法。无创、靶向递送系统的创新对于克服现有挑战和实现中枢神经系统疾病的有效治疗至关重要。本综述强调需要进一步探索这些技术,以实现持续、位点特异性的药物递送,从而推进神经疾病的治疗干预。意义声明:血脑屏障(BBB)是一个关键界面,它保护大脑但限制药物递送,在治疗中枢神经系统疾病时带来挑战。推进多学科方法和创新递送系统对于克服这些限制并实现神经疾病的有效治疗至关重要。